Marijuana plants grow in a massive tomato greenhouse in this Associated Press file photo.
AP file photo
Click here to subscribe today or Login.
Dr. William Checkley’s depth of knowledge on health studies of marijuana becomes obvious as soon as he starts talking about the subject. The associate professor in international health at Johns Hopkins Bloomberg School of Public Health rattles off what is known and unknown with equal ease.
“There is a good amount of evidence supporting the use of oral cannabinoids for chemotherapy (relief), nausea, vomiting, chronic pain symptoms, and also in cases of Multiple Sclerosis spasticity (abnormal muscle tightness),” he said during an online interview with Eyewitness News reporter Amelia Sack. “All effects are modest. In terms of chemotherapy, you get about a 40% improvement in pain control.”
But then Checkley gets to a problem common in many reports about marijuana and health.
“In general, you’ll see there is limited evidence for other conditions,” he notes. The evidence is scant regarding using cannabis to increase appetite in combating weight loss from HIV/AIDS, for example, and to help irritable bowel syndrome or epilepsy.
On the flip side of the health coin, there is some “strong evidence supporting worse respiratory symptoms with long-term cannabis use,” Checkley said. “Higher levels of coughing, phlegm and wheezing.
“We know cannabis smoking affects lung function long term,” he said. And chronic users who stop smoking marijuana, conversely, usually see improvements in lung function and respiratory symptoms. “We also know long-term cannabis use increases the risk of emphysema,” though separating the impact of marijuana from the impact of tobacco can be difficult, since many people who use one use the other.
“It’s unclear whether cannabis increases hospital admissions or exacerbation of chronic respiratory conditions like COPD (Chronic Obstructive Pulmonary Disease) or asthma. We have to have more data,” he added.
Impacts on young people?
One issue of legalizing cannabis products is the access children may get to products designed not to be smoked, but to be eaten. “One of the most worrisome concerns in terms of health is the availability of cannabis edibles,” Checkley said. “We’ve seen that in states were edibles are accessible, there’s been a rise in unintentional exposure in children, which ends up in emergency room visits and hospitalizations.
It’s a problem shared by Luzerne County District Attorney Sam Sanguedolce, who — in a separate interview — cited data showing use by minors increased in states where adult-use (21 and over) was legalized. He noted the potential impact on students who “having smoked marijuana the night before results in not being in school the next day.” The county has a substantial truancy problem already, and he fears legal adult use could make it worse.
“Recent cannabis studies (in younger people) show impairments in learning, in memory, in retention,” Checkley said. “Cannabis can have effects on academics and education” which can last well beyond school. If a student does not succeed in class, odds go up he will have a harder time later getting and holding a job.”
Efforts in other states to prevent advertising that lures younger people into use may seem strong, Sanguedolce said. New York cannabis shop owner Chris Myers said the law is stringent, banning even the use of the words cannabis or marijuana, and too much use of the color green in ads. Product packaging and ads must stick to guidelines designed to avoid appealing to youngsters. Yet Sanguedolce remains unconvinced it is, or even can be, enough.
Older people may still think of ads in print or on TV, recalling how tobacco ads were banned decades ago. But he asked if anyone is monitoring online ads, seeing what children may be exposed to in games played on smartphones, for example, or what they are exposed to through social media.
Cognitive impacts on adults
Checkley said some evidence exists that adults can be impacted cognitively as well. “There are links to mental health for sure, associations between cannabis use and schizophrenia — low level associations. We see a high relapse of psychosis in cannabis users. Heavy cannabis users may be associated with greater symptoms of bipolar disorder. They are more likely to report thoughts of suicide and social anxiety disorders,” he said.
The American Heart Association has done multiple studies and reviews of data on marijuana use with an eye on healthy lungs and brains, and found the “chemicals in cannabis have been linked to an increased risk of heart attacks, heart failure and atrial fibrillation in observational studies.”
“Marijuana users may also have an increased risk of clot-caused stroke, according to the American Heart Association’s 2022 scientific statement, Use of Marijuana: Effect on Brain Health. Studies cited in the statement found people who used marijuana had more strokes – as much as 17% to 24% more – compared to those who did not use.
“Smoking and inhaling marijuana, regardless of THC content, has been associated with heart muscle dysfunction, chest pain, heart attacks, heart rhythm disturbances, sudden cardiac death and other serious cardiovascular conditions. In U.S. states where cannabis has been legalized, an increase in hospitalizations and emergency department visits for heart attacks has been observed,” according to the American Heart Association’s 2020 scientific statement on cannabis use and cardiovascular health.
A Heart Association journal article on the topic also raised questions about drug interactions with marijuana, use by pregnant women, and use by young adults: “Overall, evidence is still inconclusive for cannabis use and adverse cardiovascular outcomes, resulting in an urgent need for carefully designed, prospective short- and long-term studies.”
The AHA article notes that the “rapidly changing landscape of cannabis laws and marijuana use” creates “a pressing need for refined policy, education of clinicians and the public, and new research.” It calls for removal of cannabis from the Schedule I drug list so more research can be done, and an increase in funding for research “proportionally to match the expansion of cannabis use, “not only to clarify the potential therapeutic properties but also to better understand the cardiovascular and public health implications that now follow the decriminalization of cannabis.”
READ THE FULL REPORT:
• Could Pa. become the Keystoned State?
• NYS shop owner shares experiences
Reach Mark Guydish at 570-991-6112 or on Twitter @TLMarkGuydish